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Hypertension

What is it?

Hypertension (hye-per-TEN-shun) is also known as high blood pressure. It occurs when the blood pressing on the inside of your arteries (blood vessels) is higher than normal. Hypertension may damage your arteries. This may make you more likely to have a stroke, heart attack, kidney problems, or heart disease. High blood pressure can cause serious health problems even if you do not feel sick. Hypertension is often called "the silent killer" because you may not have symptoms.

What may increase my risk of having hypertension? High blood pressure can be treated with medicine and lifestyle changes. Many things may increase your risk of having high blood pressure. Some examples include:

  • Smoking.
  • Having diabetes (dye-uh-BEE-teez).
  • Having a family history of heart disease.
  • Having high cholesterol (koh-LES-ter-ol).
  • Being over 60 years old.
  • Being a male.
  • Being a female who has been through menopause (the change of life).

What is blood pressure?

  • Blood pressure is a measurement of the pressures put on the blood vessel walls of your body. There are two parts to a blood pressure measurement. The systolic (sis-TOL-ik) pressure is the top or the first number in a blood pressure reading. The diastolic (dye-uh-STOL-ik) pressure is the bottom or second number in the reading. Here is an example: 120/80, 120 is the systolic number and 80 is the diastolic number. The systolic number is the strongest pressure felt by the blood vessel walls. It happens when the heart is squeezing out blood. The diastolic number is the pressure put on blood vessel walls when your heart is at rest. When saying a blood pressure, use the word "over" to replace the slash. For example, the above blood pressure would be "120 over 80."
  • High blood pressure is when the systolic number is higher than 140 or when the diastolic number is higher than 90. Only one of these numbers needs to be high to have high blood pressure. For example: 118/98, the systolic number (118) is normal, but the diastolic number (98) is high. For the blood pressure of 180/70, the systolic number (180) is high, but the diastolic number (70) is not. A good systolic number is less than 120. For some people, a number between 90 and 100 is normal. A good diastolic number is usually lower than 80 millimeters of mercury (mm Hg). Your caregiver can tell you what is normal for you.

What are the types of hypertension?

  • Prehypertension : A blood pressure that is very close to the numbers for hypertension is called prehypertension. A systolic pressure between 120 and 139 or a diastolic pressure between 80 and 89 is considered prehypertensive. Having prehypertension makes you more likely to develop an even higher blood pressure in the future. If you are prehypertensive, your caregiver may suggest lifestyle changes. If you have kidney disease or diabetes, you may need medicine to treat your prehypertension.
  • Primary hypertension : Also known as essential (ee-SEN-shul) or idiopathic (id-ee-oh-PATH-ik) hypertension. This is the most common type of hypertension and occurs in about 90% of people. The cause of primary hypertension is not known.
  • Secondary hypertension : Is usually caused by a medical condition or a medicine. Some examples include kidney disease, sleep apnea (when breathing stops for short periods during sleep), medicines such as aspirin, ibuprofen (eye-bu-PROH-fen), and pseudoephedrine (sue-doh-ee-FED-rin) (this medicine is found in some cold medicines), stress, isolated systolic hypertension (systolic number (top number) is over 160 mm Hg), and white coat hypertension (high blood pressure that only happens when you get nervous or stressed because you are in a doctor's office).

Signs and Symptoms:

You may not have any symptoms unless you have another illness, such as kidney disease. You may have one or more of the following signs and symptoms of hypertension:

  • Blurred vision or a headache.
  • Sleepiness or confusion.
  • Nosebleeds or coughing up blood.
  • Numbness or tingling in your hands and feet.
  • Shortness of breath.

Wellness Recommendations:

  • Quit smoking.
  • Lose weight if you are overweight.
  • Exercise three or more times a week if your caregiver says it is OK. Follow a heart healthy diet.

Medical Care:

Blood, urine, and other tests may be done to learn about your hypertension. You may need to take medicine to decrease your blood pressure.

HOW TO TREAT YOUR SYMPTOMS:

Hypertension is a serious health problem. The use of herbs and supplements should not take the place of good medical care.

Dietary Measures:

  • Eat healthy foods low in fat and salt and high in fiber, such as vegetables, whole grains, or fruits. Vegetarians have a lower risk of hypertension.
  • Alcohol causes blood pressure to increase in some people. If you drink alcohol, do not drink more than two drinks a day. One drink is a can of beer (12 ounces) or a 4-ounce (1/2 cup) glass of wine. It is also the same as one jigger (1 ounce) of hard liquor, such as whiskey.
  • Coffee can affect blood pressure. It is best to decrease your coffee intake. Green tea may raise your blood pressure for a short time but may decrease the risk of a stroke.

Herbs and Supplements:

Before taking any herbs or supplements, ask your caregiver if it is OK. Talk to your caregiver about how much you should take. If you are using this medicine without instructions from your caregiver, follow the directions on the label. Do not take more medicine or take it more often than the directions tell you to. The herbs and supplements listed may or may not help treat your condition

Herbs:

  • Coleus (Coleus forskolii) has been used for many years, but has not been studied in people who have hypertension.
  • Garlic (Allium sativum) is helpful in hypertension and has been studied in people.
  • Hawthorn (Crataegus oxyacantha) has been used for many years, but has not been studied in people who have hypertension.
  • Stevia (Stevia rebaudiana) may be helpful for hypertension and has been studied in people.

Supplements:

  • Arginine is helpful for hypertension and has been studied in people.
  • Calcium may be helpful for hypertension and has been studied in people.
  • Coenzyme Q-10 (ubiquinone) may be helpful for hypertension and has been studied in people.
  • Fish oil (DHA, EPA) may be helpful for hypertension and has been studied in people.
  • Magnesium may be helpful for hypertension and has been studied in people.
  • Potassium is helpful for hypertension and has been studied in people.
  • Vitamin B6 may be helpful for hypertension and has been studied in people.
  • Vitamin C may be helpful for hypertension and has been studied in people.

Complementary Therapies:

  • Learn to control your stress by using such techniques as relaxation tapes, biofeedback, meditation, or yoga.
  • Traditional Chinese medicine (TCM), which includes acupuncture and herbs, can be helpful for hypertension.

Other ways of treating your symptoms:

Other ways to treat your symptoms are available to you.

Talk to your caregiver if:

  • You would like medicine to treat hypertension.
  • Your symptoms have not gone away or improved by these self-help measures.
  • You have questions about what you have read in this document.

SEEK CARE IMMEDIATELY IF:

  • You faint (pass out) or have a seizure (convulsion).
  • You have chest pain.
  • You have a bad headache or trouble thinking clearly.
  • You have numbness or weakness on one side of your body.
  • You are having breathing problems.
  • You are coughing up blood or having nosebleeds.

Care Agreement:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss the treatment options with your caregivers. Work with them to decide what care will be used to treat you. You always have the right to refuse treatment.

References:

1. Alexander CN, Schneider RH, Staggers F et al: Trial of stress reduction for hypertension in older African Americans. II. Sex and risk subgroup analysis. Hypertension 1996; 28(2):228-237.

2. Aybak M, Sermet A, Ayyildiz MO et al: Effect of oral pyridoxine hydrochloride supplementation on arterial blood pressure in patients with essential hypertension. Arzneimittelforschung 1995; 45(12):1271-1273.

3. Brownstein AH & Dembert ML: Treatment of essential hypertension with yoga relaxation therapy in a USAF aviator: a case report. Aviat Space Environ Med 1989; 60(7):684-687.

4. Bucher HC, Cook RJ, Guyatt GH et al: Effects of dietary calcium supplementation on blood pressure-meta-analysis of randomized controlled trials. JAMA 1996; 275(13):1016-1022.

5. Chan P, Tomlinson B, Chen YJ et al: A double-blind placebo-controlled study of the effectiveness and tolerability of oral stevioside in human hypertension. Br J Clin Pharmacol 2000; 50(3):215-220.

6. Digiesi V, Cantini F, Oradei A et al: Coenzyme Q10 in essential hypertension. Mol Aspects Med 1994; 15(suppl):S257-S263.

7. Gu D, He J, Wu X et al: Effect of potassium supplementation on blood pressure in Chinese: a randomized, placebo-controlled trial. J Hypertens 2001; 19(7):1325-1331.

8. Jee SH, Miller ER III, Guallar E et al: The effect of magnesium supplementation on blood pressure: a meta-analysis of randomized clinical trials. Am J Hypertens 2002; 15(8):691-696.

9. Mullan BA, Young IS, Fee H et al: Ascorbic acid reduces blood pressure and arterial stiffness in type 2 diabetes. Hypertension 2002; 40:804-809.

10. Nakao M, Nomura S, Shimosawa T et al: Clinical effects of blood pressure biofeedback treatment on hypertension by auto-shaping. Psychosom Med 1997; 59(3):331-338.

11. Prisco D, Paniccia R, Bandinelli B et al: Effect of medium-term supplementation with a moderate dose of n-3 polyunsaturated fatty acids on blood pressure in mild hypertensive patients. Thromb Res 1998; 91:105-112.

12. Rosano GMC, Panina G, Cerquetani E et al: L-arginine improves endothelial function in newly diagnosed hypertensives. J Am Coll Cardiol 1998; 31(2 suppl. A):262A.

13. Silagy C & Neil A: A meta-analysis of the effect of garlic on blood pressure. J Hypertens 1994a; 12(4):463-468.


Last Updated: 4/4/2014

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